Current perspectives on reflux laryngitis

Abstract

Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease (GERD). With the increase of GERD patients, the importance of LPR is acknowledged widely. However, the pathophysiology of LPR is not understood completely and the diagnostic criteria for LPR remain controversial. Unfortunately, a gold standard diagnostic test for reflux laryngitis is not available. Recently, an experimental animal model for reflux laryngitis was developed to investigate the pathophysiology of reflux laryngitis. An empirical trial of lifestyle modification and proton pump inhibitor therapy is a reasonable approach for LPR symptoms. Alternatives after failure with aggressive medical treatment are limited and multichannel intraluminal impedance and pH monitoring is currently the best alternative to detect nonacid reflux. Additional prospective and evidence-based research is anticipated.

Successful treatment of radiation-induced mucositis with proton pump inhibitor administration: A report of two laryngeal cancer cases

“…It is believed that the laryngeal/pharyngeal membrane is damaged by gastric acid, but recent evidence suggests that pepsin may be responsible for the mucosal damage [6,7]. However, regardless of the factor responsible for the mucosal damage, it is reasonable to hypothesize that radiation might damage the mucosal membrane when the membrane is under LPR-related chronic stress.…”

Evaluation Symptoms Indices in Laryngopharyngeal Reflux Disease

“…(7) Ambulatory 24 hours pH monitor using a sensor 5 cm above the upper border of the manometric lower esophageal sphincter in order to accurately diagnose LPR with calculation of mean percentage of the time (pH <4) (8) …”

Swallowing in Patients With Laryngitis

“…There is a well-established association between gastroesophageal reflux disease (GERD) and reflux laryngitis syndrome (2,3) ; however, laryngitis may also be caused by tobacco, alcoholic beverages, allergies, rhinopharyngeal infections and traumatic lesions (4) .The diagnosis of laryngopharyngeal reflux of gastric content is not easy (3,5) and treatment includes proton pump inhibitors, which may or may not improve the symptoms (6,7) . Dysphagia is present in patients with GERD and in patients with laryngitis (1,6,8) . In patients with GERD, the symptom may be related to ineffective esophageal motility and also individual sensitivity (2,6,9) .…”

“…Dysphagia is present in patients with GERD and in patients with laryngitis (1,6,8) . In patients with GERD, the symptom may be related to ineffective esophageal motility and also individual sensitivity (2,6,9) . Pharyngeal phase of swallowing may be impaired, with slower bolus transit through the mouth, pharynx and upper esophageal sphincter (10,11) .…”